Why Going Home Isn’t Always Simple
It was 2 a.m. on a surgical ward in a rural hospital. The man in front of me was a 72-year-old farmer, rugged and weathered from a lifetime of work outdoors. He’d been crushed by a cow — a few fractured ribs, cuts, bruises. Every breath caused him visible pain. As the on-call anaesthetist, I was there to help manage it.
But his first question wasn’t about the pain. It was, “When can I go home?”
I paused. Gently, I told him it would likely be a while — at least until he could breathe without agony. He looked down, disappointed, frustrated. In hindsight, I shouldn’t have been surprised.
Almost everyone asks that question after an accident or illness: When can I go home? But going home doesn’t always mean being well. And more importantly, it doesn’t always mean being ready.
The emotional tension is real — between the desire to return to “normal” and the harsh reality of new limitations. Whether it’s difficulty climbing stairs, preparing food, or managing personal care, the recovery process often continues long after the hospital doors close behind us.
That’s why safe discharge planning isn’t just about the right medications or equipment — it’s about helping people understand what life at home might look like now, and how to plan for support.
Discharge from the hospital does not mean that everything is “back to normal.”
For older adults, even short hospital stays or minor injuries can lead to long-lasting effects. Research indicates that older adults can lose as much as 5% of their muscle mass per day during bed rest (Kortebein, 2008). What a healthy 30-year-old might recover from in weeks could signify the end of independence for someone in their 70s or 80s. A simple fracture, a period of bed rest, or just a few days of reduced mobility can result in lasting loss of function, especially if the person was already frail.
Even in cases like that of our resilient farmer, the impact of injury or inactivity largely depends on their physical condition prior to admission. For those who are not as fit, this might mean an inability to climb stairs or a need for assistance with tasks like washing and meals. These changes can be significant—both practically and emotionally.
The desire to return home is often associated with the hope of resuming life as it once was. However, illness and injury, particularly later in life, can fundamentally change our physical abilities. Accepting these new limitations is a profound challenge and starkly contrasts the typical trajectory of our lives, which often involves the gradual lifting of restrictions—like the end of childhood bedtimes, obtaining a driver’s license, or gaining the freedom to choose where we live. Suddenly imposed restrictions, especially within the familiar environment of home, can feel like a cruel paradox.
This loss of independence can evoke a deep sense of grief. As Kübler-Ross outlined in her stages of grief - not exclusively tied to death - loss encompasses more than just mortality. It includes the loss of abilities that have defined one's identity and daily life for decades. For the farmer, it might mean the inability to tend to his land with the same vigor. For others, it could involve simple tasks such as driving to the shops, climbing the stairs to bed, or managing personal care tasks like dressing or bathing. Accepting this new reality takes time, often creating a period of adjustment at odds with the urgent desire to leave the clinical setting of the hospital.
So, what strategies can families implement to ease the transition for older adults returning home?
To facilitate this transition, families can take several proactive steps. Establishing a clear plan prior to discharge is helpful. This may include arranging for modifications in the home to enhance safety and accessibility, such as installing grab bars or ensuring that frequently used items are within easy reach. Involving the older adult in this process can help them feel more in control and comfortable. Additionally, regular check-ins and open discussions about their feelings, needs, and concerns can foster a supportive environment during this adjustment period.
Continue reading - Part 2: How Small Setbacks Affect Independence
How Gladys home care can help?
At Gladys, we understand that the first step is the hardest and that these transitions aren't easy for families or the person needing care.
We’re more than a care provider - we’re your local partner across Bath, Bristol, North East Somerset, Wiltshire, South Gloucestershire, Bournemouth, Poole, and Christchurch. From supporting your loved ones hospital discharge after a hospital stay to providing flexible care at home near Bath and home care Bristol, our private home care for elderly and domiciliary care solutions ensure seniors receive the right support. Whether they need light house cleaning services for seniors, meal prep, or respite care Bournemouth, our trusted private carer network delivers personalised companionship and elderly support when your family need it most.
Find local support now
